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The Practice of Nurse Practitioners in Thailand’s Primary Health Care Context
Ratchatawan Sritragool, RN, MSN, PhDc
Khanitt Nuntaboot, RN, MSN, PhD
The Faculty of Nursing, Khon Kean University
Background: Thailand’s health reforms under the country’s universal health insurance coverage act with the limitation resources to provide sufficient health services, more demands on primary health care quality, and more partnerships involve, the Nursing council has designed to strengthen nurses’ capacity to be nurse practitioners (NPs). Their practices are to provide comprehensive primary health services. Apart of NPs’ professional experiences, the health policy and health care context also influence their practice.
Purpose: To investigate the advanced practice and to critique the primary health care context affecting NPs’ roles; to identify competencies needed to acquire expertise; and to develop a proposal of the care for NPs.
Methods: Using an ethnographic approach, data were collected through participant observations, interviews, focus group discussions and field note recordings. The field work was carried out in primary health care settings in northeast Thailand. Thirty-two NPs participated.
Preliminary results: The findings were: 1) NPs provide care across the life span of target population under social-economic-cultural community context; home visit of patients with health problems through a holistic approach ; capacity building to health volunteers; and mentor local government organizations to manage social determinants of health. 2) As health policy indicators require outdoor activities, NP’s have to working collaboration with community members and related agencies on health prevention and promotion. Therefore they are requited to maintain a balance of activities to fulfill their responsibilities and working culture. 3) Competency skills requiring improvements include i) data management to design a home visit program; ii) capacity of psychiatric ,youth , HIV/ AIDS , people who require assistance and substance abuse manage care; iii) working collaboration with related agencies ; iv) understanding health and public policy issues and 4) A draft of the proposal of the care for NPs.
Implications: For both practice and instruction, NPs’ capacities need to be strengthened in such areas as data management, psychiatric, youth , HIV/ AIDS , people who require assistance and substance abuse manage care, working collaborative skills and policy issues competences . Further research on monitoring and evaluation of the program implementation for NPs is recommended.
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